Hemangioma: Understanding and Management
Introduction:
Hemangioma, a benign growth arising from vascular cells of blood vessels, primarily affects infants under one year old, with approximately 10% of newborns presenting hemangiomas since birth.
Causes:
The precise etiology of hemangiomas remains unclear, but potential factors include maternal cold during early pregnancy, birth trauma, twin pregnancy, advanced maternal age, fetal deformities, premature birth, and exposure to toxins like nicotine and alcohol.
Symptoms:
External hemangiomas are visually and tactually identified, commonly observed on the face, eyelids, neck, or forehead, and may vary in color. Pressing superficial hemangiomas results in palpability due to blood pooling. Internal hemangiomas’ symptoms are complex and may be asymptomatic until significant vessel spread occurs.
Treatment Options:
- Topical therapy with beta-blockers, like timolol gel, offers promising results, halting growth and inducing involution if necessary.
- Oral beta-blocker therapy is preferred for large or critical location hemangiomas.
- Laser removal, using pulsed dye laser, is effective and safe, gradually consolidating blood vessels and removing layers of the tumor.
- Surgical excision is considered in specific cases, along with cryodestruction or sclerotherapy for unsuitable locations.
Management in Infants:
Infants with hemangiomas require regular monitoring by a vascular specialist. Treatment strategies are tailored based on location and severity, often involving multidisciplinary approaches with specialists in obstetrics, pediatrics, urology, ENT, maxillofacial surgery, or thoracic surgery.
Prevention:
No specific preventive measures exist, but reducing the risk of viral infections during pregnancy and ensuring timely childbirth are crucial considerations.
Conclusion:
Understanding hemangiomas’ etiology, symptoms, and treatment options is essential for effective management. A multidisciplinary approach, tailored to individual cases, ensures optimal outcomes in infants with hemangiomas.